Internal Medicine Alert
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Dulaglutide Injection (Trulicity™)
The FDA has approved a third long-acting, once-weekly, glucagon-like peptide (GLP-1) receptor agonist for the treatment of type 2 diabetes mellitus, joining exenetide ER and albiglutide. Dulaglutide is made up of two identical human-based GLP-1 analogs linked to a modified human IgG4 Fc fragment. This makes the molecule resistant to degradation by DPP-4, slows absorption, reduces renal clearance, and extends the elimination half-life to approximately 5 days. Dulaglutide is marketed by Eli Lilly as Trulicity.
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Angiotensin Receptor Blockers for Hypertension
Angiotensin receptor blockers (ARBs) are often used as first-line therapy for the treatment of systemic hypertension because of their perceived efficacy and relatively low incidence of adverse effects.
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Colchicine for Recurrent Pericarditis
Although colchicine has been shown to be effective for the treatment of acute pericarditis and first recurrences, little information exists about its use in patients with multiple recurrences.
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Clinical Briefs
Distinguishing the major differences within the class of beta-blockers; delay in the diagnosis of hepatocellular carcinoma; and a closer look at an under-recognized form of orthostatic hypotension.
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Isavuconazonium Sulfate Capsules and Injection (Cresemba ®)
Isavuconazole provides an alternative for the treatment of invasive aspergillosis and mucormycosis.
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Can Dietary Intervention Delay the Onset of Alzheimer’s Disease?
Targeted nutritional interventions are an evidence-based and safe means of reducing the risk of Alzheimer's disease and cognitive decline.
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Lowering LDL with Ezetimibe
The combination of simvastatin and ezetimibe resulted in significantly lower LDL levels and a lower risk of cardiovascular events than occurred in patients who are treated with statin monotherapy.
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Zinc Supplementation: A Risk for Copper Deficiency
Zinc deficiency is frequently misdiagnosed based on a low level without considering albumin concentration and/or an inflammatory state.
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ECG Review: Sinus Tachycardia with Tall, Peaked T Waves
If told that this patient was having new-onset chest pain we would wonder why his heart rate is so fast, and we would clearly be concerned that the prominent T wave peaking might be ischemic or a DeWinter T wave equivalent.
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Clinical Briefs
In this issue: flat basal insulin, another possible interventional fix for atrial fibrillation, and a glimmer of hope for beta-blockers in heart failure from diastolic dysfunction.